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The Early Word: Consumer Care

President Obama takes his message on the road again today, heading to Raleigh, N.C., and then to Bristol, Va., for back-to-back sales pitches on health care.

On the first stop at Broughton High School, he’ll hold another town-hall meeting. At the second, inside a Kroger grocery store, he’ll meet with employees. During these events, Mr. Obama will deliver a newly packaged message, aimed at consumers. According to several reports, the White House’s preview includes these bullet points on the president’s health-care agenda:

1. No Denials for Pre-Existing Conditions: Insurers would be banned from refusing coverage based on medical history.

2. No Huge Out-of-Pocket Expenses, Deductibles or Co-Pays: Insurers would be bound by annual caps on charges for out-of-pocket expenses.

3. Preventive Care: Insurers would be required to cover checkups and tests like mammograms or diabetes screenings.

4. No Drops in Coverage for Major Illnesses: Companies would be barred dropping or diluting coverage for those who become seriously ill.

5. No Gender Disparities: Companies could not charge differently based on gender.

6. No Annual or Lifetime Caps on Coverage:

7. Expanded Coverage for Young Adults: Family plans would cover people through age 26.

8. Renewal Guarantees: If premiums are paid, policies have to be renewed even if new illnesses emerge.

(In a “pre-rebuttal” to Mr. Obama’s visit to Bristol, the state’s former attorney general, Jerry Kilgore, will hold a teleconference call, according to the Republican National Committee.)

Christina Romer, head of the administration’s Council of Economic Advisers, also will hold a town-hall meeting online to answer questions from small businesses about health insurance reform.

As the president sought on Tuesday to assuage Medicare recipients’ concerns that health care reforms would usurp their benefits, members of Congress tried to forge some deals of their own with mixed results. Six hours of negotiations between Rahm Emanuel, the White House chief of staff, and fiscally conservative Democrats ended Tuesday night without a resolution, The Times’ Robert Pear and David Herszenhorn wrote, but the Senate Finance Committee made strides toward a bipartisan compromise.

At Time magazine, Karen Tumulty shares an interview with Mr. Obama on health care, in which he estimates he’s spending about a third of every day thinking about the issue. He also swatted away suggestions that he and his administration have offered only a broad outline of what they would like to see in legislation, preferring to let Congress haggle over and then own the details.

He insisted that he had defined a public option, saying “it shouldn’t be something that’s simply a taxpayer-subsidized system that wasn’t accountable, but rather had to be self-sustaining through premiums and that had to compete with private insurers.”

Asked about the idea of a co-op plan, something that has gained some traction in the Senate, Mr. Obama added: “Well, I think in theory you can imagine a co-operative meeting that definition. Obviously sort of the legal structure of it is less important than practically how can it operate. There are concerns that in the past, attempts at setting up co-ops have not been successful because they just haven’t been able to get off the ground; sort of the start-up energy involved may not exist if you’re doing a state-by-state co-op effort as opposed to a broad national plan.”

Preventing Terror: Homeland Security Secretary Janet Napolitano will speak to the Council on Foreign Relations Wednesday about how the Obama administration plans to prevent future terrorist attacks on U.S. soil. The Wall Street Journal wrote that Ms. Napolitano’s strategy will have roots in the policies of the previous administration. Based on an interview with her, the Journal notes:

Some Democratic lawmakers had been critical of the D.H.S. during the Bush administration for not working closely enough with state and local officials on counterterrorism. Ms. Napolitano’s strategy aims to patch up frayed relations with other levels of government by expanding efforts to tap information and expertise in state and local agencies.

A key component of the integration efforts is a national network of roughly 70 so-called intelligence-fusion centers. They bring federal, state and local officials under the same roof to “fuse” terrorism-related intelligence.

Sotomayor Vote: The Senate Judiciary Committee sent Judge Sonia Sotomayor’s confirmation to the Senate floor Tuesday for a vote. Democrats are confident they have the 60 votes necessary for Ms. Sotomayor to be confirmed. But Republicans have shown that they’re not going to take it easy on Mr. Obama as he tries to fill federal court vacancies nationwide, according to the Times’s Neil Lewis.

Trial Closings: The trial of former Representative William Jefferson, Democrat of Louisiana, goes to closing arguments Wednesday. The Congressman faces bribery, racketeering, money laundering and obstruction of justice charges stemming largely from his efforts to promote contracts in Africa for iGate, a small digital-technology company based in Louisville, Ky.

Mr. Jefferson was influential in African affairs during his time in Congress, which included membership on the House Ways and Means Committee and the Congressional Black Caucus. But in this criminal case, he is best known as the congressman who federal agents said had stashed $90,000 of bribe money in his freezer.

Dodd’s Mortgage: Senator Chris Dodd asserted on Tuesday that he did not receive better rates on a mortgage from Countrywide than others, despite new reports emerging from ethics inquiries. “My conscience is clear in terms of what we did,” Mr. Dodd said, according to CQ. “We negotiated loans. We shopped. The rates they gave us were readily available to the general public. It’s not like it’s hidden information. … I’m completely mystified as to why this persists as a question.”

Birthdays and the ‘Birthers’: The Senate followed the House, and passed a resolution that not only marked the 50th birthday of the state of Hawaii, but also included language affirming that the president — despite fringe rumors to the contrary — was born in Hawaii in 1961 and is a United States citizen.

Nothing that preserves fee-for-service as the foundational health care business model, not even single-payer, will produce lasting cost containment.
The only one that will is the pure HMO model, where groups of providers compete to offer care to patients for a fixed monthly fee, regardless of the amount of care required.
To offset adverse selection, HMOs would be required to accept all applicants, but those that accept disproportionate numbers of high-risk patients could draw on subsidy pools funded by taxes on HMOs with lower-risk profiles.
Patients would be able to switch HMOs at any time; when they do, they could make informed choices based on extensive audited outcomes data (risk-adjusted), that each HMO would be required to post online.
The advantages: all providers retain strong profit incentives based on reducing the cost of care they provide instead of increasing it, consistent with maintaining quality, consumers retain choice with limits, and government’s role as cost arbiter is severely limited.

The eight bullets are all that is needed to provide a fair system for all Americans. This is basically the plan available to federal legislators, except the extended childhood provision.

After Dodd and Conrad, is there anyone left who believes Democrats have more integrity than Republicans? Understand the recently indicted New Jersey politicos were mostly Democrats, but only WSJ will hint at this.

For the birthers, it may be more than just the issue of the birthplace of the president. I suspect that many would prefer to see a president born to parents who were both born in America. Hillary fits the bill!

Let’s set aside another distraction, a baseless, nominal, and minimal coverage by the health industry-sponsored some senators. A new Gallup Poll released late last week shows that 71 percent of Americans want health care reform including public option, with a substantial number calling for reform to come sometime this year. A pay for outcome / value payment system, key to the deficit-neutral, might be capable of bringing all groups together.

Supporters of the agreement say it could save the Medicare System more than $100 billion a year and ‘improve’ care, that means more than $1trillian over a decade, and virtually needs no other resources including tax on the wealthiest. (Please visit //www.kare11.com/news/news_article.aspx?storyid=820455&catid=391 for detailed infos).

As much as 30 percent of all health-care spending in the U.S. -some $700 billion a year- may be wasted on tests and treatments that do not improve the health of the recipients,” Thus the remaining $239 billions over a decade do not matter.
Dr. Armadio at Mayo clinic says, “If we got rid of that stuff, we save a third of all that we spend and that is 2.5 trillion dollars on health care. A third of that and that is 700 billion dollars a year. That covers a lot of uninsured people.”

1. There is no need for infighting and class conflict.

2. It can satisfy revenue-neutral raised by the Republicans.

3. It is able to resolve the regional disparity.

4. It may bring the private insurers to competition, innovation.

5. The focus on ‘outcome’ over volume can make the practitioners more accurate and creative based on IT SYSTEM and evidence, while eliminating the additional, unnecessary care that is increasing patients’ pains, frustrations, and possible side-effects.

Sounds like Obama may push a simple law to accomplish his 8 points. Hard to see how Republicans can object. Rates may go up since the 8 points raise benefits (eliminating lifetime limits, imposing annual cost limits), but the addition of a “soak the rich” tax (or maybe even the botax) will pay for that.

Jane Smith reminds us of Bush who was in perpetual campaign for the increase wealth of bank CEOs and the heads of insurers.

Today there is a president out campaigning to make sure that everyone gets health care and to make sure that our health and finance dollar goes for the purpose it was intended. That purpose is service not CEO enrichment.

Trial Closings: The trial of former Representative William Jefferson, Democrat of Louisiana, goes to closing arguments Wednesday. The Congressman faces bribery, racketeering, money laundering and obstruction of justice charges stemming largely from his efforts to promote contracts in Africa for iGate, a small digital-technology company based in Louisville, Ky.

Mr. Jefferson was influential in African affairs during his time in Congress, which included membership on the House Ways and Means Committee and the Congressional Black Caucus. But in this criminal case, he is best known as the congressman who federal agents said had stashed $90,000 of bribe money in his freezer.
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Just curious, would this be any different from how the insurance company is buying off/bribing our congressional leader??????

Complex, and especially new, government programs and legislation are perpetually investigated for minute details by smart people looking for financial gain not anticipated by most legislators. Detection and repair often takes years. That is why change, especially at the federal level, should always be incremental.

Most of the items termed “Consumer Care” are government mandates that will drastically increase private health insurance premiums. Some of us have been making this argument since H.R.3200 was released.

To use the “auto body shop” analogy that President Obama likes, some of us want insurance to cover the high costs associated with auto accidents and, in exchange for lower premiums, we’ll pay for the lube jobs out of pocket. Same thing with deductible thresholds.

On #4 above, when companies bail on people who become sick, then State laws should already allow the Attorneys General to step in. The insurance industry is heavily regulated — by the States.

On #7 above, in my State young adults can stay on a family plan up to the age of 25.

On #8 above, this is a good idea but it’s one for the States to address, not the Federal government.

The worst thing that could happen to health care is to extend rather than eliminate the HMO model. With HMO business concerns are the only outcome that is considered. With monitoring of cost effectiveness doctors and patients set the agenda and the only say that payers have is to do it effectively.

HMO sets the relationship as payer and patient. The payer is in some office in a distant state who the purchaser of service never meets. The only use HMOs are good for is to salary non health care providers in the health care industry.

One problem with the “let the states decide” approach. Federal law, ERISA, preempts state law and allows private employers to arrange for health coverage that does not staidfy every state’s law. That is the only way an employer that has operations in multiple states can have a consistent healh care program. Therefore, you need a federal law to cover Obama’s points, at least for health plans sponsored by private employers.

NC asked: “After Dodd and Conrad, is there anyone left who believes Democrats have more integrity than Republicans? ”

Are all Democrats prefect in the integrity department? Far from it. Are they anywhere near as bad as the Republicans? Far from it.

Aside from the handful of Democrats who received a ton of money from the healthcare industry that they sold their souls, for, also known as the “blue dogs,” It is Republicans that are pushing to stop millions and millions of Americans from receiving lifesaving medical care.

With the encroaching environmental holocaust that virtually every major climate scientist on the planet is desperately warning us about, it is overwhelmingly Republicans who are trying to spin the facts for the polluters while we circle the drain towards extinction.

It is Republicans who have been blocking measures to protect women’s health and equal pay.

It is Republicans who have been pushing an agenda of slashing taxes for the rich and cutting aid for the poor, for a very long time now.

It is Republicans that manufactured the case for an illegal war, costing hundreds and hundreds of thousands of human lives and a trillion dollars.

Maybe Obama needs to spend more time bending the arms of Democrats in Congress than going out to sell a program when no one knows yet what it will contain.
If the public option is eliminated, as the winds from the Senate Finance committee seem to indicate, it will just be more of the same with maybe a few concessions to pre-existing conditions.
I’m also disappointed with the timing in these bills – it sounds like nothing will be in place for about three years, and we need the reforms in the individual market yesterday. One quick fix, would be to let people over 55 buy into Medicare if they want – that could be implemented this year.
Perhaps rather than compromising on the public option it would be better for the Dems to compromise on tort reform for malpractice. Time to stand up to the trial lawyers lobby as well as the health industry lobbies.

The more I hear about this the more I am concerned that we will become a super sized country. Currently 10% of health care costs are spent on obesity related illnesses. If you require coverage for all, with all paying the same price you will eliminate any incentive to live a healthy lifestyle. I will be paying for those who deiced to ignore health warnings.

Unless the Governement is going to step in an force people to be healthy I thinkn the US will continue to spiral into obesity.

This is more smoke and mirrors from Obama. Here are the questions he should be asked. Can you guarantee that there won’t be rationing? Can you guarantee that Americans will always have the option to chose their own doctors and their own health insurance? Can you guarantee that senior citizens won’t be shortchanged in their health care at the expense of the younger (read into that non income tax payers and possibly illegal aliens) population? Can you guarantee that the younger generation who grow up to be tax paying hard-working citizens won’t be stuck with the huge bill for Obama’s experiment? Can you guarantee that the middle class will not have to shoulder the financial burden for this? Can you guarantee that if a government doctor makes a serious error in a patient’s care that the government will be legally accountable and can be sued? And finally why is that Congress gets an all-comprehensive elite insurance package that we tax payers subsidize? Obama’s talking points are meant to distract people from the real issues but it’s not going to be so easy this time. This time Americans are talking back.

It’s a good idea to go look for actual data if you want to know who actually gets industry money. For the 2008 campaign, Obama’s name kept popping up, and he wasn’t even running for reelection. For 2010, it is more disbursed. Schumer, Gillibrand, Reid, Lincoln, Miller seem to be raking in the cash.

President Obama drew criticism on Thursday when he said, “we don’t have a strategy yet,” for military action against ISIS in Syria. Lawmakers will weigh in on Mr. Obama’s comments on the Sunday shows.Read more…